Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011;15(6):R292.
doi: 10.1186/cc10585. Epub 2011 Dec 10.

Vitamin D deficiency is associated with mortality in the medical intensive care unit

Sindhaghatta Venkatram  1 , Sridhar Chilimuri, Muhammad Adrish, Abayomi Salako, Madanmohan Patel, Gilda Diaz-Fuentes
Affiliations

Vitamin D deficiency is associated with mortality in the medical intensive care unit

Sindhaghatta Venkatram et al. Crit Care. 2011.

Abstract

Introduction: The incidence of vitamin D deficiency in critically ill patients has been reported to range from as low as 17% to as high as 79%. Data regarding the relationship between 25-hydroxyvitamin D levels and outcomes in the medical intensive care unit are sparse. The goal of the study was to evaluate the prevalence of 25-hydroxyvitamin D deficiency in the medical intensive care unit and its relationship with outcomes.

Method: This was a retrospective study in a medical intensive care unit (MICU) at an inner city community hospital. The study period was between October 2009 and February 2010.

Results: Of the 932 patients admitted during the study period, 25-hydroxyvitamin D vitamin D (25(OH)D) levels were available in 523 (53%); 86 of them were excluded from the study due to readmission to the intensive care unit. Deficiency was defined as 0 to 19.9 ng/dL 25(OH)D levels, insufficiency as 20 to 29.9 ng/dL, and normal levels as ≥30 ng/dL. Of the 437 patients studied, 25(OH)D deficiency was identified in 340 (77.8%), insufficiency in 74 (16.9%), and normal levels in 23 (5.3%) patients. Patients with 25(OH)D deficiency/insufficiency were younger (P = 0.015), were male (P = 0.001), and had kidney disease (P = 0.017) and lower total serum calcium levels (P = 0.003). Hospital mortality was higher in patients with 25(OH)D deficiency (P = 0.01). No differences in ventilator days or length of stay in the MICU were evident among the three groups. Analysis by multiple logistic regression demonstrated that acute physiology and chronic health evaluation (APACHE) IV score ((odds ratio (OR) 1.036; 95% confidence interval (CI) 1.024-1.048, P < 0.0001), ventilator requirement (OR 7.7; 95% CI 4.3-13.98, P < 0.0001), 25(OH) D levels(OR 0.942; 95% CI 0.942-0.904, P < 0.0005) and 25(OH) D deficiency (OR 8.7; 95% CI 1.03-72.8, P < 0.0469) showed statistical significance. There was no association between 25(OH)]D insufficiency and hospital mortality. The mean 25(OH)D level of survivors (27.9 ± 9.7 ng/dL) was higher than for non-survivors (9.7 ± 4.7 ng/dL; P < 0.0001).

Conclusions: The study results demonstrate an association between 25(OH)D deficiency and hospital mortality in MICU patients. A randomized prospective study to evaluate the effect of vitamin D replacement therapy on mortality is warranted.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of patients in the cohort.
Figure 2
Figure 2
Vitamin D receiver operating curve. Vitamin D receiver operating characteristic curve revealing an area under the curve of 0.66.
Figure 3
Figure 3
Vitamin D intersection curve. Vitamin D intersection curve revealing sensitivity at 59.8% and specificity at 58% for a vitamin D level of 10 ng/dL.
Figure 4
Figure 4
Comparison of patients with available 25-hydroxyvitamin D levels versus patients without 25-hydroxyvitamin D levels.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Norman AW, Bouillon R, Whiting SJ, Veith R, Lips P. 13th Workshop Consensus for Vitamin D Nutritional Guidelines. J Steroid Biochem Mol Biol. 2007;103:204–205. doi: 10.1016/j.jsbmb.2006.12.071. - DOI - PMC - PubMed
    1. Dobnig H, Pilz S, Scharnagl H, Renner W, Seelhorst U, Wellnitz B, Kinkeldei J, Boehm BO, Weihrauch G, Maerz W. Independent association of low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med. 2008;168:1340–1349. doi: 10.1001/archinte.168.12.1340. - DOI - PubMed
    1. Lee JH, O'Keefe JH, Bell D, Hensrud DD, Holick MF. Vitamin D deficiency: an important, common, and easily treatable cardiovascular risk factor? J Am Coll Cardiol. 2008;52:1949–1956. doi: 10.1016/j.jacc.2008.08.050. - DOI - PubMed
    1. Zittermann A, Gummert JF, Börgermann J. Vitamin D deficiency and mortality. Curr Opin Clin Nutr Metab Care. 2009;12:634–639. doi: 10.1097/MCO.0b013e3283310767. - DOI - PubMed
    1. Melamed ML, Michos ED, Post W, Astor B. 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med. 2008;168:1629–1637. doi: 10.1001/archinte.168.15.1629. - DOI - PMC - PubMed

MeSH terms